The effects of suggestion and emotional arousal on pulmonary function in asthma: a review and a hypothesis regarding vagal mediation.

Abstract

This paper reviews the empirical literature on the relation between asthma, suggestion, and emotion, and proposes the hypothesis that these effects are mediated parasympathetically. The literature indicates that, among asthmatics, suggestion can produce both bronchoconstriction and bronchodilation, and that stress can produce bronchoconstriction. The proportion of asthmatic subjects showing bronchoconstriction to both suggestion and stress averages 35%-40% across studies, but, because of methodological considerations, might be conservatively estimated as closer to 20%. The effect is smaller for suggestion of bronchodilation, and is very short-lived among nonasthmatics. No clear connection has been found between these responses and such subject variables as age, gender, asthma severity, atopy, or method of pulmonary assessment, although some nonsignificant tendencies appear. Most studies in this literature used small n's and did not systematically examine various somatic, environmental, and demographic factors that could influence results. A hypothesis is presented regarding vagal mediation of psychological effects on the airways, as well as possible alternative mechanisms, and recommendations for future research to evaluate these hypotheses.

Generalized Anxiety Disorder is Associated With Reduced Lung Function in the Vietnam Experience Study

“…The present findings also resonate with those from experimental studies showing that induced negative emotions elicit bronchoconstriction, particularly in asthma patients (22)(23)(24).…”

Guidelines for mechanical lung function measurements in psychophysiology

“…Research has also shown that modifications of airway resistance by experimental suggestions can be abolished by parasympathetic blockade~for review, see Isenberg, Lehrer, & Hochron, 1992!. Induced emotions, stress, and mood states have been linked to changes in the resistive properties of the airways in health and disease~e.g., Kotses, Westlund, & Creer, 1987;Ritz, Steptoe, DeWilde & Costa, 2000!.…”

Psychological Factors in Asthma and Psychoeducational Interventions

“…Among different respiratory illnesses asthma presents the most profound links between psychological, social, biological and physiological factors. This is why it is considered the prototype of psychosomatic diseases (Isenberg et al, 1992;Lehrer et al, 1993;Mackenzie, 1886). Much has been achieved since the 1960s, with the psychoanalytic approach to asthma in children, viewed as crying repression (French & Alexander, 1941).…”